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Workers' Compensation

Missouri Lowers Burden for Mental Stress Claims

What does a claimant have to prove for work-related stress when their job is inherently stressful?

Mantia v MoDot, 2015 MoWCLR Lexis 39 (lexis.com), 2015 MoWCLR Lexis 39 (Lexis Advance) (
April 28, 2015) charts a much lower bar for claimants to receive compensation, and it reverses a denial of benefits.


The causation is undisputed in this case.  Both the employer and the employee's experts agree that claimant's job as a highway worker caused permanent psychological injury which exposed her to "horrific scenes of carnage, death and human tragedy over 20 years."   Claimant asserts she witnessed over 1,000 accident scenes, that she would joke with co-workers about the carnage, and in 2008 she "eventually" developed symptoms and sought treatment. 

The ALJ denied benefits and found the worker failed to establish her burden that the stress was extraordinary or unusual compared to others in the same profession.  An expert indicated dealing with this trauma was "part and parcel" of the job as a highway worker. 

The Commission reversed the denial, and found the expert's rating of 2.5% to be "extremely low" and awarded claimant 50% BAW based on expert testimony that claimant became depressed,  cynical, angry, depressed and socially withdrawn.  The Commission based its rating on a diagnosis of depression, and did not adopt the opinion of the treating physician that claimant developed post traumatic stress disorder. 

Section 287.120.8 (lexis.com), Section 287.120.8 (Lexis Advance), before reform required  parties seeking injuries for mental stress injuries to evaluate similarly situated employees in order to show stress was extraordinary and unusual. The ALJ in Mantia found that claimant proved that her work was very stressful but did not offer evidence that her work was more stressful compared to other highway workers.  Her expert offered no opinion on the issue.

Williams v DePaul Health Center, 996 S.W.2d 619 (lexis.com), 996 S.W.2d 619 (Lexis Advance),  (Mo App. 1999) noted the legislature did not identify what objective standards and actual events were required to establish a compensable mental claim and that the Commission could consider as a proper comparison group those individuals in a comparable work environment.  "The proper comparison for purposes of Section 287.120.8 is to compare Employee's work-related stress with the stress encountered by employees having similar positions, regardless of employer, with a focus on evidence of the stress encountered by similarly situated employees for the same employer."  Claimant failed in her burden of proof in Williams because she did not demonstrate the stress encountered by other hematologists within the  stat lab either for this Employer or for any other employer. The employee  urges the Commission's standard improperly imposed on her a new and greater evidentiary burden.

The commission's position now adopts the losing argument in Williams how to define the proper comparison group.  An attorney for the claimant in Williams was appointed as chairman of the Labor and Industrial Relations Board in 2013.

Mantia reverses a long line of cases which followed Williams, including the Commission's own unanimous decision in March 2015 to deny mental stress benefits to a prosecutor.  "We believe employee's job duties as a prosecutor were inherently stressful and were undoubtedly rendered more stressful by employee's home-life stressors and preexisting psychiatric problems. But the evidence convinces us that employee was not subjected to greater work-related stress than his co-workers." Kersten v Jackson County, 2015 MO WCLR Lexis 19 (lexis.com), 2015 MO WCLR Lexis 19 (Lexis Advance).  (March 5, 2015).  

The commission in Mantia essentially concluded the comparison within the same profession deprived workers of benefits who were most at risk of injury because their job was inherently stressful which produced an irrational result when causation was not contested.   Claimant must show the events are extraordinary but the definition of extraordinary was based on the nature of the events themselves and not comparisons to co-workers.    "We cannot conclude that the stress employee experienced was anything other than extraordinary and unusual when, in the course of her work for employer, she listened helplessly to the screams of a child as he burned to death, accidentally kicked an accident victim's decapitated head, stepped on teeth scattered across an accident scene, breathed air filled with the scent of burning flesh, or observed the crushed skull of a coworker, to mention but a few of the many terrible events employee described in her testimony. We are confident that all rational minds [would agree with us].' It follows "It would be "unjust, unreasonable, or absurd" (not to mention supremely ironic) to interpret 287.120.8  to deny compensation to this employee...."

The Williams standard required workers in inherently stressful jobs had to show a little something more to prove a mental claim.  This extra step sometimes created a default when the worker did not introduce such evidence.   Mantia signals in cases in which causation of mental stress is not disputed that  there is very little to talk about any more.

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug’s Mo. Workers’ Comp Alerts.

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